- Wage Index Tables Final Rule and Correction Notice
- CMS Mix and Case Index
- Wage Index Tables
- Wage Index
- Case Mix Index
- Lugar Hospitals
- Social Security Act
- Geographic Reclassification of Hospitals
Case Mix Index And Wage Index Table By CCN Final Rule
This dataset contains the non-transfer adjusted Case Mix Index (CMI) based on the Medicare Severity Diagnosis Related Groups (MS-DRGs) billed on the claim in the year the claim was incurred.
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Section 1886(d)(3)(E) of the Social Security Act requires that, as part of the methodology for determining prospective payments to hospitals, the Secretary must adjust the standardized amounts “for area differences in hospital wage levels by a factor (established by the Secretary) reflecting the relative hospital wage level in the geographic area of the hospital compared to the national average hospital wage level.” This adjustment factor is the wage index. We currently define hospital geographic areas (labor market areas) based on the definitions of Core-Based Statistical Areas (CBSAs) established by the Office of Management and Budget and announced in December 2003. The wage index also reflects the geographic reclassification of hospitals to another labor market area in accordance with sections 1886(d)(8)(B) and 1886(d)(10) of the Act. Note that in the FY 2012 IPPS final rule, Centers for Medicare and Medicaid Services (CMS) finalized a policy that allows a Lugar hospital that is eligible for and accepts the outmigration adjustment to automatically waive its urban status for the 3-year period for which the outmigration adjustment is effective.
1.The CCNs with a “B” in the 4th position indicate a campus of an MCH located in a different CBSA from the main provider. The campus’s wages and hours are allocated to the CBSA of its physical location. The wage index reflects the CBSA of its location, or the MGCRB reclassified wage index, if applicable. The case-mix index and average hourly wages are not separated by campus; they reflect the provider as a whole.
2.A blank indicates FY 2018 MedPAR (which is used for the FY 2020 rates) was not available for the provider, and therefore, this provider was not included in the rate setting process.
3.This is the hospital’s FY 2020 wage index with all applicable adjustments.
4.A blank indicates wage data not available for the CCN for the fiscal year or all three fiscal years.
5.Hospitals cannot receive the out-migration adjustment if they are reclassified under section 1886(d)(10) of the Act or redesignated under section 1886(d)(8)(B) of the Act or redesignated under section 1886(d)(8)(E) of the Act.
6.For FY 2020 the wage index for hospitals with a wage index value below the 25th percentile wage index increased. Based on the data for the final rule, the 25th percentile wage index value across all hospitals is 0.8457. The proposed increase in the wage index for these hospitals would be equal to half the difference between the otherwise applicable final wage index value for a year for that hospital and the 25th percentile wage index value for that year across all hospitals.
Implemented a transition of a 5-percent cap on any decrease in a hospital’s wage index from the hospital’s final wage index in FY 2019.
Please see section III.N. of the preamble of the final rule for a complete discussion regarding these policies.
About this Dataset
John Snow Labs; Centers for Medicare and Medicaid Services;
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|Source License Requirements||
Wage Index Tables, Wage Index, Case Mix Index, Lugar Hospitals, Social Security Act, Geographic Reclassification of Hospitals
Wage Index Tables Final Rule and Correction Notice, CMS Mix and Case Index
|CMS_Certification_Number||CMS Certification Number||string||-|
|Indexes_For_Discharges_Occurring_In_Federal_Fiscal_Year_2019||Case-Mix Indexes for Discharges Occurring in Federal Fiscal Year 2019||number||level : Nominal|
|Wage_Index_2020||Wage Index CCN Correction Notice for FY 2020||number||level : Nominal|
|Wage_Index_Prior_To_Quartile_And_Transition_2021||Wage index prior to quartile and transition for fiscal year 2021||number||level : Nominal|
|Wage_Index_With_Quartile_2021||Wage index with quartile for fiscal year 2020.||number||level : Nominal|
|Wage_Index_With_Quartile_And_Cap_2021||Wage index with quartile and cap for fiscal year 2020||number||level : Nominal|
|Average_Hourly_Wage_FY_2019||Average Hourly Wage Index Correction Notice for FY 2019||number||level : Nominal|
|Average_Hourly_Wage_FY_2020||Average Hourly Wage Index CCN for FY 2020||number||level : Nominal|
|Average_Hourly_Wage_FY_2021||Average Hourly Wage Index for FY 2021||number||level : Nominal|
|Average_Hourly_Wage_2019_2020_2021||3-Year Average Hourly Wage (2019, 2020, 2021)||number||level : Nominal|
|Geographic_CBSA||Geographic Core-Based Statistical Areas||string||-|
|Reclassified_Redesignated_CBSA||Reclassified or Redesignated Core-Based Statistical Areas||string||-|
|Lugar_NECMA||Lugar New England County Metropolitan Area (NECMA)||string||-|
|Is_MGCRB_Reclassified||Medicare Geographic Classification Review Board (MGCRB) reclassified||boolean||-|
|Is_MGCRB_Reclassified_To_Home||MGCRB reclassification to home area||boolean||-|
|Is_Hospital_Reclassified_As_Rural||Hospital Reclassified as Rural Under Section 1886(d)(8)(E) of the Act (412.103)||boolean||-|
|Out_Migration_Adjustment||Out-Migration Adjustment related to Wage Index||number||level : Nominal|
|County_Code||County Code||number||level : Nominal|
|Is_Dual_Status_412_103_MGCRB_LUGAR||Is a hospital is located in a LUGAR county or qualified for reclassification (MGCRB||boolean||-|
|CMS Certification Number||Indexes For Discharges Occurring In Federal Fiscal Year 2019||Wage Index 2020||Wage Index Prior To Quartile And Transition 2021||Wage Index With Quartile 2021||Wage Index With Quartile And Cap 2021||Average Hourly Wage FY 2019||Average Hourly Wage FY 2020||Average Hourly Wage FY 2021||Average Hourly Wage 2019 2020 2021||Geographic CBSA||Reclassified Redesignated CBSA||Lugar NECMA||Is MGCRB Reclassified||Is MGCRB Reclassified To Home||Is Hospital Reclassified As Rural||Out Migration Adjustment||County Name||County Code||Is Dual Status 412 103 MGCRB LUGAR|